POS1529-HPR SEXUAL DYSFUNCTION AND QUALITY OF LIFE IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: W. Tański, K. Dudek, N. Świątoniowska-Lonc
Journal: Annals of the Rheumatic Diseases (2022)

Background Sexual health is a major component of human well-being. The World Health Organization (WHO) defines sexual health as “a state of physical, mental, emotional, and social well-being in relation to sexuality”. Sexuality is a very important, inherent part of human functioning. As repeatedly shown in research, satisfaction with sex life and sexual fulfillment correlate positively with quality of life (QoL) in most of its aspects. It is thus true that a reduced quality of one’s sex life and lack of sexual fulfillment can contribute to poorer QoL overall. As poor sex life quality and sexual dissatisfaction result from sexual dysfunction, effective treatment of such a dysfunction can be assumed to contribute significantly to a better QoL. Objectives To describe an assessment of sexual problem among RA patients as a part of patient-reported outcome measures assessment. Methods 171 consecutive RA patients (mean age 48.3±14.6) attending the rheumatology outpatients clinic over 6 months in 2021. Standardized questionnaires were used in the study: The Sexological Questionnaire to assess self-assessment of the incidence of sexual disorders, WHOQOL-BREF to assess QoL level, Disease Acceptance Scale and VAS scale to assess pain intensity. Results The mean duration of the disease in the study group was 13±9 years. The mean score of subjective assessment of mobility was 6.2 ± 1.6, and the mean score of the DAS-28 disease activity index was 4.0±1.9. The study group presented a mean level of disease acceptance (AIS 29.6 ± 11.6). The comparative analysis showed significant differences in reaching orgasm and declared sexual dysfunctions. These problems occurred more often in women than in men (34.2% vs. 18% and 43% vs. 40% respectively p=0.002). In univariate analysis, factors correlating positively with the frequency of declaring sexual dysfunction were: subjective motor score less than 6 points, AIS&lt;36 points, WHOQOL-BREF&lt;59 points, disease activity ≥3.5 points and VAS&gt;3. In multivariate logistic regression analysis independent factors positively correlating with frequency of sexual dysfunction declaration were: general QoL (β=1.255; p=0.035) and pain limiting social life (β=1.564; p=0.030). The absence of comorbidities correlated negatively and reduced the prevalence of sexual dysfunction (β=-1.030, p=0.043). Patients with reduced QoL had 3.5 times and patients with pain limiting social life had 4.8 times higher risk of sexual dysfunction than other patients. In contrast, those without comorbidities were 2.8 times more likely to be free of sexual dysfunction than those diagnosed with other chronic diseases besides RA. Conclusion Sexual dysfunction is a problem found both in women and in men with RA. The most common problems include lack of orgasm, vaginal dryness in women, and erectile dysfunction in men. Psychological factors that contribute to sexual dysfunction include low or no illness acceptance and poor QoL. The absence of comorbidities is an independent determinant of lower sexual dysfunction incidence, whereas low QoL and pain limiting the patient’s social life are independent determinants of increased incidence of sexual dysfunction in both sexes. References [1]Hunter TM, Boytsov NN, Zhang X, et al. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004-2014. Rheumatol Int. 2017;37:1551. [2]Tristano AG. Impact of rheumatoid arthritis on sexual function. World J Orthop. 2014;5(2):107-11. [3]WHO. Sexual and Reproductive Health and Research (SRH). Definition. URL: https://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=&amp;cad=rja&amp;uact=8&amp;ved=2ahUKEwjS3fS6gZr1AhXS66QKHbGwDHkQFnoECAwQAQ&amp;url=https%3A%2F%2Fwww.euro.who.int%2Fen%2Fhealth-topics%2FLife-stages%2Fsexual-and-reproductive-health%2Fnews%2Fnews%2F2011%2F06%2Fsexual-health-throughout-life%2Fdefinition&amp;usg=AOvVaw20satnO_o687QKq2N8ELi0 [Accessed: 05.01.2022]. [4]Oettingen J. Sexual dysfunction – approach based on cognitive theory. Polish sexology 2013;11(2):68-75. Disclosure of Interests None declared